Project Description/associated implementation:To meet the increasing demand for a technology-enabled healthcare ecosystem, states must navigate complex stakeholder relationships and gain consensus for financing strategies as well as governance of health IT assets. In many states, Medicaid agencies are tapping federal funds available through the HITECH Act to help finance the implementation of population health and data analytics tools. Working closely with private sector stakeholders and other state agencies is critical to maximize the available funding for the IT investments necessary for health transformation. CedarBridge Group proposes a panel focused on how diverse states are financing and governing health IT systems for population health management and analytics. This panel would be comprised of representatives from State Innovation Model (SIM) testing states (Colorado, Connecticut, and Oregon) and North Dakota, a state moving forward without the additional driver of SIM funding.

Target Audience for Discussion Group: State program managers, agency leaders in Medicaid agencies and state and county public health officials, and other state officials, hospital and health plan representatives, accountable care organizations (ACOs), and all types of healthcare organizations participating in alternative payment models (APMs), researchers, consultants and vendors.

Why the topic/project is at the leading edge of health IT, health and human services transformation Information exchange between health and social services systems is currently the exception, not the rule in communities across the country. However, states are planning for the future with the assistance of a generous, but time-limited funding source that was recently expanded by CMS and announced on February 29, 2016 in a State Medicaid Directors letter. States are working quickly to establish strategies to provide the required matching funds to draw down federal funds in order to implement technology that will enable better care coordination and quality measurement across healthcare providers and over time, with social services, justice systems, and community support organizations.

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore

]]>http://www.healthcareitconnect.com/financing-the-implementation-of-health-it-to-improve-population-health-2/feed/0Transition Times: Sustaining Innovation to Build a More Responsive, Cost Effective H&HS Systemhttp://www.healthcareitconnect.com/transition-times-sustaining-innovation-to-build-a-more-responsive-cost-effective-hhs-system/
http://www.healthcareitconnect.com/transition-times-sustaining-innovation-to-build-a-more-responsive-cost-effective-hhs-system/#commentsTue, 29 Nov 2016 04:27:37 +0000HITC Editorhttp://www.healthcareitconnect.com/?p=16879Healthcare IT Connect is currently planning a number of sessions at the 2017 State HIT Connect Summit, March 28-29 specifically to explore the policy and fiscal levers that could be utilized by the Trump administration to ‘repeal and replace’ or ‘modify’ the Affordable Care Act as well as to assess the likely impact on the State H&HS transformation programs including the funding for HIT and the modernization of Medicaid and integrated H&HS systems.

Transition sessions will include discussions on strategic planning issues including:

• Exploring the impact of replacement options for the Affordable Care Act, associated timelines and what this means for states?

• If Medicaid block granting is introduced, how could states sustain H&HS innovation efforts?

• What will Medicaid IT modernization look like and how could CMS’ Modularization Initiative be impacted?

• What will be the future for the State Innovation Model (SIM) Program?

• What will be the role for Value Based Care, could the MACRA Law be impacted?

• What support will be provided for Veterans populations and behavioural health integration/connectivity?

• What will be Trump administration’s approach to solving interoperability challenges and what will is the vision for the Health IT Policy and Standards Committees?

• Will there be a renewed focus on Telehealth and Remote Patient Monitoring?

• Cybersecurity – what direction will renewed focus take?

APHSA Releases Transition Report to President-Elect & CongressThe American Public Services Association (APHSA) released a Transition Report to President-Elect and Congress entitled ‘Creating a Modern and Responsive Health and Human Services System’ highlighting new approaches to H&HS transformation that are ‘innovative, efficient, effective and responsive to the needs of a rapidly changing society’. Click here to read the full paper.

The 2-day program brings together public and private sector thought leaders to share ideas and benchmark implementation strategies of State health IT systems as they move forward with diverse health and human services transformation programs.

Project Description/associated implementation: This presentation will include a detailed study of a natural experiment enabled by the public health IT transformation efforts of Montgomery County, Maryland, a large suburban county. Montgomery County has been engaged in on-going efforts to improve public health services leveraging new IT systems. Notably, the Montgomery County Department of Health and Human Services (DHHS) and a public-private network of safety net clinics supported by the Primary Care Coalition of Montgomery County (PCC) embarked on the process of implementing an EHR that supports coordination across Social, Somatic, Dental and Behavioral Health Services. The EHR aimed to provide greater visibility of patient information across service areas and more efficient communication and management of information both internally and externally. Qualitative and quantitative data collection techniques were used. We conducted an intensive analysis of this EHR implementation across PCC and DHHS facilities (12), using interviews (61), observations (16), patient focus groups (3) and surveys (55.5% overall response rate) of EHR users before and after the EHR implementation, and client chart reviews (67), which provided a rich qualitative record. Staff participating in the study included DHHS and PCC clinical providers, administrative and client services staff, and managers at multiple levels across worksites including Access to Social and Health Services, Behavioral Health Programs, Public Health Clinics, and Public Health Dental Services. Patients included in this study typically received a mix of somatic, behavioral and social services through the health department. A detailed chart review was conducted to enable our understanding of the use, breadth, capability, interaction and usability of both legacy and existing systems. The experiences of implementing PHIT and the factors important to successful value realization were distilled and assessed for Index inclusion. Survey data was analyzed using factor analytic strategies to assess the reliability and validity of subscales and their conceptual structure, and t-tests and multivariate regression provided inferential insights. The factor analysis included components relating to pre and post-implementation staff perceptions of: Information Gaps; EHR Impacts; Perceived Usefulness; Perceived Ease of Use; Future Use Intentions; Knowledge about System; and Training. The factors in combination with controls for demographics, employment history, and computer literacy were used in the regression models.

Further, a Delphi exercise was conducted with six experts representing public health systems at the state and local level and multi-stakeholder national groups. The Index design, narrative and corresponding questionnaire received written feedback, followed by a virtual focus group to obtain further feedback. Experts were asked to provide feedback on how instructive and measureable Index elements were, which elements needed to be added, changed or removed, and how to best design the Index to reflect macro and micro-level areas of importance. After the virtual focus group, a refined model was distributed for a concluding round of written comments, which were incorporated into the final PHIT Maturity Index.

Background: Public health information technology (PHIT) has the potential to improve the effective and efficient use of information in achieving public health objectives. Information technology maturity models have been extensively used in other domains to guide information technology assessment and planning, but an information technology maturity model tailored for public health departments has heretofore been unavailable.

Purpose: The purpose of this study was to develop a Public Health Information Technology Maturity Index.

Methods: An extensive literature review and content analysis was conducted of information system adoption, use, and maturity in general and in the public health systems and services research context in particular. Primary data were collected through staff interviews (61), staff observations (16), patient focus groups (3), and staff surveys (3) over the course of a multi-year technology implementation, including pre- and post-implementation of an electronic health record system at a large suburban public health department. Data were analyzed using qualitative and quantitative methods to extract potential categories for inclusion in the index. A Delphi exercise whose panelists included experts from state and local public health departments and national multi-stakeholder groups was conducted.

Results:A Public Health Information Technology Maturity Index, questionnaire, and scoring guide were created. The Maturity Index consisted of four primary categories: Scale and Scope of PHIT Use; PHIT Quality; PHIT Human Capital, Policy and Resources; and, PHIT Community Infrastructure, along with fourteen subdimensions. Implications: The PHIT Maturity Index represents a practical approach to aid public health system stakeholders, notably health departments, in the evaluation of their information technology deployment decisions. As benchmark data become available, it will enable comparative assessment and possible linking of information technology maturity and multi-agency interoperability to population health outcomes. Research article details at: http://uknowledge.uky.edu/frontiersinphssr/vol5/iss2/5/ Video brief about the research: http://go.umd.edu/PHITMIVideo

Why the topic/project is at the leading edge of health IT, health and human services transformation Medical records should follow a patient no matter where the patient is in the care continuum. This includes geographic boundaries. Recognizing the cross border care sought by those living near state lines and travelers, UHIN, the state-designated HIE in Utah, has partnered with the HIEs in Arizona and western Colorado to share ADTs when patients living in one HIE have a medical encounter at a facility participating in an HIE in another state. In the few months since ADTs began being sent across state lines, more than 4,000 have been sent. SUCCESS STORY: A Colorado pathologist was notified his patient had been admitted to a Utah hospital, and through his own HIE was able to access the Utah-generated CCD. From the CCD he was able to review the patient’s lab work, and use it as a baseline for the follow up care, ensuring far better coordinated care.

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore

Project/associated implementation Description:In December 2015, the Centers for Medicare and Medicaid Services (CMS) issued the Mechanized Claims Processing and Information Retrieval Systems (90/10) Final Regulation. The new rule not only makes the availability of enhanced funding for eligibility and enrollment (E&E) and Medicaid Management Information Systems (MMIS) permanent, but it also allocates additional funding for commercial off-the-shelf solutions (COTS) and software as a service (SaaS) modular products rather than complete systems, which provides an opportunity for new technology vendors to enter the Medicaid technology space.

There are significant questions from states, vendors, and consultants regarding how to effectively implement and meet the requirements of the rule including: how to develop new procurement vehicles, how to effectively define the business and technical components of the modules, the requirements that will be needed for better interoperability and re-use between services and products, API development, module pre-certification, opportunities for new product vendors, and more. Given these needs and a desire not to compete with existing efforts, many feel there is a need for a higher-level strategic discussion regarding how to meaningfully and efficiently advance these concepts.

In 2016, Leavitt Partners, NESCSO, and CMS convened multiple state, vendor, and consulting representatives to discuss the formation and next steps for a Medicaid Technology Alliance. The goals of the meetings were to: discuss common challenges in moving towards modular technology adoption, how to organize around key themes and workgroups, and determine a vision for the future of Medicaid technology.

This presentation will provide an update on the Alliance’s progress to date, how other states and interested parties can get involved, and describe the alliance’s vision for the future.

]]>http://www.healthcareitconnect.com/the-medicaid-technology-alliance/feed/0Integrating Behavioral Health and Pharmacy Support into Community-Based Primary Care Settingshttp://www.healthcareitconnect.com/integrating-behavioral-health-and-pharmacy-support-into-community-based-primary-care-settings/
http://www.healthcareitconnect.com/integrating-behavioral-health-and-pharmacy-support-into-community-based-primary-care-settings/#commentsMon, 01 Aug 2016 20:15:15 +0000HITC Editorhttp://www.healthcareitconnect.com/?p=16574NewHealth Collaborative is a physician-led accountable care organization that supports its primary care physician members in their transformation to advanced primary care practices. One effective mechanism that has been employed to improve patient outcomes and decrease cost of care is the integration of care management support services into 100+ primary care sites. To date, this support team (which is employed centrally but deployed out to local offices) has included a small core of RN care managers, LSW care managers, and health coaches. NewHealth Collaborative is working to identify how it can provide more integrated behavioral health and pharmacist support to primary care settings in which an “embedded” model of deployment is not sustainable.

The IT infrastructure that is being assessed to support a more virtual integration of support services includes (but is not limited to): data aggregation and analysis programs that provide a more robust mechanism to identify potential patients for proactive outreach, and allows for tracking of patient progress and outcomes over time; technology solutions to facilitate the engagement of specialty support services for the patient and their primary care team, including tele-medicine solutions and asynchronous communication mechanisms; and the use of web-based, patient-directed programs for ongoing monitoring of progress in between conventional office visits.

Come join this discussion to share ideas and brainstorm about alternative mechanisms to augment primary care teams across a community with these centralized support services.

]]>http://www.healthcareitconnect.com/integrating-behavioral-health-and-pharmacy-support-into-community-based-primary-care-settings/feed/0MHN ACO:Virtually Integrated, Community Based Healthcarehttp://www.healthcareitconnect.com/mhn-acovirtually-integrated-community-based-healthcare/
http://www.healthcareitconnect.com/mhn-acovirtually-integrated-community-based-healthcare/#commentsWed, 22 Jun 2016 20:30:15 +0000HITC Editorhttp://www.healthcareitconnect.com/?p=16396Chicago’s Safety Net. Established in 2014, the Chicago-based MHN ACO, LLC is a provider-owned collaborative comprised of 9 Federally Qualified Health Centers and 3 Hospital Systems and their Physician Practices operating in a unique egalitarian structure where each provider has an equal voice. Under this leadership and in partnership with local not-for-profit Medical Home Network, MHN ACO has implemented a community-based, practice-level model of care.

With a growth rate of 34 percent a year and an estimated 187 wearable, health-related devices in circulation by 2020, mHealth and wearable health technology are being explored as a significant value add to the doctor-patient relationship. But the technology remains in fledgling stage—fitness and health tracking features are still often clumsy, and lack consistency. Meanwhile, connected medical homes are catching on as effective ways to ease communications between providers and patients, monitor patient medical data (and manage that data in the clinic), and reduce the need for costly office visits. Does this mean that mHealth and Connected Medical Homes could form a perfect union? Or will interest in wearables fade away? Keep up on the latest trends in this valuable session.

The continuum of care concept has required the integration of raw data at every stage of a patient’s healthcare, from office visits to hospitalizations, from medications to palliative end-of-life care. Getting meaningful analytics means integrating databases from clinics, laboratories, and payor records as well as hospital quality data, disease registries and public access rates. But without the right tools and structures, this process can be very labor intensive. Find out how states have developed IT infrastructures that can provide a window of care at every step.

Now, integrated programs are needed that will improve community health and provide measurable statistical results and reduce healthcare costs. Success will depend on a shift in focus from the clinic to the population at large, and adapting provider practices, data collection and analysis. At this sessios panelists wille explore the integration of clinical, claims as well as external data including socio-economic data, access to critical support services and patient generated data and the ability to analyze this data and to make it actionable across the accountable care enterprise to optimize this new public health environment.

View the HD Video Presentation: Doug and Cheryl discuss CCH&HS Transformation to County Based Integrated Organization and its roles as Provider, Payor, Public Health Department, and Network Leader through clinical integration, community engagement, and advanced Health IT systems to support